Glaucoma medication
AI overview
Glaucoma medication is divided into groups based on chemical structure and pharmacologic action.
Key points
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Glaucoma medications are classified by chemical structure and pharmacologic action
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Glaucoma medication is divided into groups based on chemical structure and pharmacologic action.
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The goal of glaucoma therapy is to preserve visual function by lowering IOP in patients with increased intraocular pressure
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The goal of currently available glaucoma therapy is to preserve visual function by lowering intraocular pressure (IOP) in patients that have an increased intraocular pressure.
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IOP-lowering treatment slows progression of visual field loss in primary open-angle glaucoma and ocular hypertension
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medical intraocular pressure lowering treatment slowed down the progression of visual field loss
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Common clinical agents include prostaglandin analogs, parasympathomimetics, carbonic anhydrase inhibitors, adrenergic antagonists, alpha 2 agonists, hyperosmotic agents, nitric oxide donators, and rho kinase inhibitors
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Agents in common clinical use include:
Symptoms
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Latanoprost can cause eyelash pigmentation, eyelid skin pigmentation, red eye, and flu-like symptoms
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pigmentation of eyelashes, eyelid skin pigmentation, hyperemia (red eye), flu-like symptoms (joint/muscle pain and headache)
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Bimatoprost and travoprost can cause blurred vision, eyelid redness, eye discomfort, permanent iris darkening, and eyelash changes
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blurred vision, eyelid redness, eye discomfort, permanently darken iris, darken/thicken eyelashes
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Timolol can cause bronchospasm, bradycardia, depression, and impotence
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bronchospasm, bradycardia, depression, impotence
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Brimonidine can cause blurring, foreign body sensation, eyelid edema, dryness, headache, fatigue, hypotension, depression, and insomnia
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blurring, foreign body sensation, eyelid edema, dryness, headache, fatigue, hypotension, depression, insomnia
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Pilocarpine can cause posterior synechia, keratitis, miosis, brow ache, cataract, myopia, retinal tear, dermatitis, and increased salivation
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posterior synechia, keratitis, miosis, brow ache, cataract, myopia, retinal tear, dermatitis, increased salivation
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Dorzolamide and brinzolamide can cause eye irritation and bitter taste
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eye irritation, bitter taste
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Acetazolamide can cause malaise, depression, weight loss, and kidney stones
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malaise, depression, weight loss, kidney stones
Treatment
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Prostaglandin analogs (latanoprost, bimatoprost, travoprost) increase uveoscleral outflow, dosed once daily, reducing IOP by 25-32%
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Increased USO (uveoscleral outflow ) Once daily 25-32%
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Timolol decreases aqueous production, dosed every 12 hours, reducing IOP by 20-30%
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Decrease aqueous production Every 12 hours 20-30%
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Betaxolol decreases aqueous production with fewer pulmonary complications due to selective beta blockade
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Fewer pulmonary complications due to selective Beta blockage
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Brimonidine decreases aqueous production and increases uveoscleral outflow, dosed every 8-12 hours, reducing IOP by 20-30%
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Decrease aqueous production, increase USO every 8–12 hours 20-30%
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Pilocarpine increases trabecular outflow, dosed every 6-12 hours, reducing IOP by 15-25%
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Increase trabecular outflow Every 6–12 hours 15-25%
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Carbonic anhydrase inhibitors (dorzolamide, brinzolamide, acetazolamide) decrease aqueous production, reducing IOP by 15-20%
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Decrease aqueous production Every 8–12 hours 15-20%
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Fotil is a combination drug containing pilocarpine and timolol
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Fotil is a combination drug consisting of:
Red flags
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Timolol can cause bronchospasm and bradycardia
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bronchospasm, bradycardia
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Brimonidine can cause hypotension and depression
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hypotension, depression, insomnia
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Pilocarpine can cause retinal tear
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retinal tear
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Acetazolamide can cause kidney stones
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kidney stones
Prognosis
Medical intraocular pressure lowering treatment slowed down the progression of visual field loss in patients with primary open-angle glaucoma and ocular hypertension.
AI-synthesized from the Wikipedia article “Glaucoma medication”. Not medical advice.
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| Glaucoma medication | |
|---|---|
Latanoprost | |
| Specialty | Ophthalmology |
Glaucoma medication is divided into groups based on chemical structure and pharmacologic action. The goal of currently available glaucoma therapy is to preserve visual function by lowering intraocular pressure (IOP) in patients that have an increased intraocular pressure.
Agents in common clinical use include:[1][2]
- Prostaglandin analogs
- Parasympathomimetic (miotic) agents, including cholinergic and anticholinesterase agents
- Carbonic anhydrase inhibitors (oral and topical)
- Adrenergic antagonists (nonselective and selective Beta1-antagonists)
- Alpha 2 agonists
- Hyperosmotic agents
- Nitric oxide donators[3]
- Rho kinase inhibitors
When comparing people with primary open-angle glaucoma and ocular hypertension, medical intraocular pressure lowering treatment slowed down the progression of visual field loss.[4]
| Name | Other names | Mechanism of action | Dosage | IOP decrease | Side effects |
|---|---|---|---|---|---|
| Prostaglandin analogs | |||||
| Latanoprost | Xalatan | Increased USO (uveoscleral outflow ) | Once daily | 25-32% | pigmentation of eyelashes, eyelid skin pigmentation, hyperemia (red eye), flu-like symptoms (joint/muscle pain and headache) |
| Bimatoprost | Lumigan | Increased USO (uveoscleral outflow ) | Once daily | blurred vision, eyelid redness, eye discomfort, permanently darken iris, darken/thicken eyelashes | |
| Travoprost | Travatan | Increased USO (uveoscleral outflow ) | Once daily | blurred vision, eyelid redness, eye discomfort, permanently darken iris, darken/thicken eyelashes | |
| Beta blockers | |||||
| Timolol | Timoptic | Decrease aqueous production | Every 12 hours | 20-30% | bronchospasm, bradycardia, depression, impotence |
| Betaxolol | Betoptic | Decrease aqueous production | Every 12 hours | 15-20% | Fewer pulmonary complications due to selective Beta blockage |
| Adrenergic agents | |||||
| Brimonidine | Alphagan | Decrease aqueous production, increase USO | every 8–12 hours | 20-30% | blurring, foreign body sensation, eyelid edema, dryness, headache, fatigue, hypotension, depression, insomnia |
| Miotics | |||||
| Pilocarpine | Isoptocarpine, Pilocar | Increase trabecular outflow | Every 6–12 hours | 15-25% | posterior synechia, keratitis, miosis, brow ache, cataract, myopia, retinal tear, dermatitis, increased salivation |
| Carbonic anhydrase inhibitors | |||||
| Dorzolamide | Trusopt | Decrease aqueous production | Every 8–12 hours | 15-20% | eye irritation, bitter taste |
| Brinzolamide | Azopt | Decrease aqueous production | Every 8–12 hours | 15-20% | eye irritation, bitter taste |
| Acetazolamide | Diamox | Decrease aqueous production | Every 6–12 hours | 15-20% | malaise, depression, weight loss, kidney stones |
Fotil is a combination drug consisting of:[5]
- ↑ Basic and clinical science course (2011–2012). Glaucoma. American Academy of Ophthalmology. ISBN 978-1-61525-117-9.
- ↑ Myron Yanoff; Jay S. Duker (2009). Ophthalmology (3rd ed.). Mosby Elsevier. ISBN 978-0-323-04332-8.
- ↑ "Nitric Oxide-Donating Drugs for IOP Lowering".
- ↑ Vass, C.; Hirn, C.; Sycha, T.; Findl, O.; Bauer, P.; Schmetterer, L. (2007-10-17). "Medical interventions for primary open angle glaucoma and ocular hypertension". The Cochrane Database of Systematic Reviews. 2007 (4) CD003167. doi:10.1002/14651858.CD003167.pub3. ISSN 1469-493X. PMC 6768994. PMID 17943780.
- ↑ FASS (drug formulary): Fotil. Retrieved 2015-02-17